Table 1 Eligibility criteria as defined by the PICOS approach
Population | People diagnosed with major NCDs [2, 65,66,67] such as CVD, chronic pulmonary disease, cancer, T2D, osteoarthritis, back pain, and osteoporosis with no age range, gender, race, ethnicity, or geographical location limitation. Individuals who were not diagnosed with any of the aforementioned conditions, or were solely described as at-risk populations for these conditions, were excluded |
Interventions | All interventions that utilized digital technology to improve PA behavior in various forms of information technology and health communication (computer- and internet-based, mobile health, SMS, virtual reality, and videogames, electronic programs) and wearable technology (pedometer, accelerometer, fitness trackers, smart watch, etc.). These features should have been used either as comprising the whole intervention program or as a main component of the intervention in terms of monitoring and feedback, content delivery, execution of intervention, and communication between health professionals and patients. DIs are defined as programs that provide information and support (emotional, decisional, and/or behavioral) for physical and/or mental health problems via a digital platform (website or computer) [68]. Interventions not meeting the definition were excluded |
Comparators | All types of non-digital comparison groups: 1. Individuals who received no intervention (e.g., wait-list control) and/or minimal intervention 2. Individuals who received “treatment as usual” (e.g., face-to-face PA programs without the use of digital technology or only for PA measurement) or another intervention approach |
Outcomes | Reviews were included if PA was the primary outcome assessed in the reviews. PA could be measured objectively (e.g., using movement sensors such as accelerometers, pedometers, etc.) or subjectively, using self-reported measurements (e.g., through questionnaires, diaries, etc.). The outcomes encompassed low-, moderate-, and vigorous-intensity PA, number of steps, frequency of PA (for various types of activities such as strength, aerobic, balance, and flexibility exercises), and the percentage of individuals meeting PA guidelines Reviews that focused solely on sedentary behavior such as sitting time were excluded |
Study design | All systematic reviews, with or without meta-analysis of randomized controlled trials were included in this study. Systematic reviews that focused on non-randomized trials, non-controlled trials, cross-sectional studies, or cohort studies were excluded. Additionally, other study designs such as trials, cohorts, quasi-experimental studies, non-systematic reviews, commentaries, letters, and study protocols were excluded According to the Cochrane Handbook [63] a systematic review is a type of study that attempts to identify, appraise, and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a specific research question. To produce more reliable findings to inform decision making, researchers conducting systematic reviews use explicit, systematic methods that are selected with a view aimed at minimizing bias |